Early abnormalities related to postinfarction Wallerian degeneration: evaluation with MR diffusion-weighted imaging
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Published on: February 16, 2016
1Department of Radiology, University of North Carolina School of Medicine, Chapel Hill 27599-7510, USA.
Purpose:
Wallerian degeneration (WD) is most commonly seen after cerebral infarctions and results in persistent neurological deficits. MRI may detect changes related to WD as early as 4 weeks after the insult. We sought to determine if MR diffusion-weighted imaging (DWI) detects changes of WD during the acute period that follows a cerebral infarction.
Method:
Eleven patients with cerebral infarctions underwent DWI within 72 h of the onset of symptoms. DWI was performed using a high diffusion gradient strength (B = 1,000) in a single axis and trace imaging. We reviewed all images with special attention to the signal intensity in the location of the corticospinal tracts.
Results:
Ten patients harbored 11 middle cerebral artery (MCA) infarcts, and one patient had an anterior cerebral artery (ACA) infarction. Only one patient with an MCA infarct showed a subtle abnormality in the ipsilateral corticospinal tract. The patient with the ACA infarct showed an abnormality in the region of the corticopontine tract.
Conclusion:
As used in this study, DWI depicted presumed early WD in only 20% of instances.
Insights
Diffusion-weighted imaging (DWI) rarely detects early Wallerian degeneration (WD) within 72 hours after a cerebral infarction. This study found DWI depicted presumed early WD in only 20% of acute stroke cases.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Wallerian degeneration (WD) is a common consequence of cerebral infarction, leading to lasting neurological deficits.
- Magnetic resonance imaging (MRI) can detect WD changes approximately 4 weeks post-insult.
Purpose of the Study:
- To investigate the efficacy of diffusion-weighted imaging (DWI) in detecting early Wallerian degeneration (WD) during the acute phase following a cerebral infarction.
Main Methods:
- Eleven patients with cerebral infarctions underwent DWI within 72 hours of symptom onset.
- DWI utilized high diffusion gradient strength (B = 1,000) with single-axis and trace imaging.
- Image analysis focused on signal intensity within the corticospinal tracts.
Main Results:
- Out of 11 infarcts (10 MCA, 1 ACA), only one MCA infarct showed subtle ipsilateral corticospinal tract abnormality.
- The patient with an anterior cerebral artery (ACA) infarct exhibited an abnormality in the corticopontine tract region.
Conclusions:
- Diffusion-weighted imaging (DWI), as applied in this study, identified presumed early Wallerian degeneration in only 20% of acute cerebral infarction cases.
